The University of Southampton
University of Southampton Institutional Repository

A feasibility study evaluating if the cardiac model of rehabilitation is more effective than standard care in reducing cerebrovascular risk factors post Transient Ischaemic Attack

A feasibility study evaluating if the cardiac model of rehabilitation is more effective than standard care in reducing cerebrovascular risk factors post Transient Ischaemic Attack
A feasibility study evaluating if the cardiac model of rehabilitation is more effective than standard care in reducing cerebrovascular risk factors post Transient Ischaemic Attack
Background: Atherosclerosis is the leading cause of death in the UK and is the most common cause of stroke, TIA and heart attack. Most of the risk factors for atherosclerosis are shared by both stroke and cardiac patients and are linked to lifestyle factors such as diet, exercise and smoking.

Addressing lifestyle factors plays an important role in secondary prevention, and patients with heart disease who undertake cardiac rehabilitation programs involving exercise and education sessions, can reduce the risk of cardiac mortality by 26% (Joliffe 2001). The widespread availability of cardiac rehabilitation programs contrasts with the limited lifestyle support available for stroke patients, with only 37% of patients receiving verbal advice from their doctor (Rudd 2004).

Aims: To investigate the feasibity of conducting a randomised controlled trial requiring TIA and minor stroke patients to participate in a standard NHS cardiac rehabilitation programme. The trial will also evaluate the suitability of outcome measures for assessing if the intervention will significantly reduce the risk of secondary cardiovsacular events more effectively than standard care.

Methods: A single blinded randomized controlled feasibility trial was conducted with patients randomised to standard care or standard care and cardiac rehabilitation. Baseline measurements were taken one month post event with end point data collection six months post event.

Results: Twenty four patients (18 TIA, 6 minor stroke) completed the trial and provide evidence that it is feasible for stroke patients to undertake a programme of cardiac rehabilitation the effect of which can be assessed with a battery of risk factor and quality of life measures. Group analysis showed a significantly greater reduction in the primary outcome measure of Cardiovascular Disease (CVD) risk score for subjects in the intervention group in relation to standard care(intervention 25.7 ± 22.8 to 23.15 ± 18.3, control 25.03 ±15.4 to 27.12 ± 16.1, t=-1.81, P<0.05). There were also significant improvements for the intervention group in activity levels and aspects of health related quality of life.

Conclusion: Current secondary prevention strategies for stroke patients are reliant upon pharmacological therapies for managing a lifestyle related disease. This is the first trial to suggest that existing NHS lifestyle modification programmes are an effective and feasible means of reducing the risk of future cardiovascular events.
Kirk, Hayden
1b9f399d-c61d-46bb-b744-af0749d0a0ea
Kirk, Hayden
1b9f399d-c61d-46bb-b744-af0749d0a0ea
Ashburn, Ann
818b9ce8-f025-429e-9532-43ee4fd5f991
Conway, Joy
bbe9a2e4-fb85-4d4a-a38c-0c1832c32d06

(2012) A feasibility study evaluating if the cardiac model of rehabilitation is more effective than standard care in reducing cerebrovascular risk factors post Transient Ischaemic Attack. University of Southampton, Faculty of Health Sciences, Doctoral Thesis, 247pp.

Record type: Thesis (Doctoral)

Abstract

Background: Atherosclerosis is the leading cause of death in the UK and is the most common cause of stroke, TIA and heart attack. Most of the risk factors for atherosclerosis are shared by both stroke and cardiac patients and are linked to lifestyle factors such as diet, exercise and smoking.

Addressing lifestyle factors plays an important role in secondary prevention, and patients with heart disease who undertake cardiac rehabilitation programs involving exercise and education sessions, can reduce the risk of cardiac mortality by 26% (Joliffe 2001). The widespread availability of cardiac rehabilitation programs contrasts with the limited lifestyle support available for stroke patients, with only 37% of patients receiving verbal advice from their doctor (Rudd 2004).

Aims: To investigate the feasibity of conducting a randomised controlled trial requiring TIA and minor stroke patients to participate in a standard NHS cardiac rehabilitation programme. The trial will also evaluate the suitability of outcome measures for assessing if the intervention will significantly reduce the risk of secondary cardiovsacular events more effectively than standard care.

Methods: A single blinded randomized controlled feasibility trial was conducted with patients randomised to standard care or standard care and cardiac rehabilitation. Baseline measurements were taken one month post event with end point data collection six months post event.

Results: Twenty four patients (18 TIA, 6 minor stroke) completed the trial and provide evidence that it is feasible for stroke patients to undertake a programme of cardiac rehabilitation the effect of which can be assessed with a battery of risk factor and quality of life measures. Group analysis showed a significantly greater reduction in the primary outcome measure of Cardiovascular Disease (CVD) risk score for subjects in the intervention group in relation to standard care(intervention 25.7 ± 22.8 to 23.15 ± 18.3, control 25.03 ±15.4 to 27.12 ± 16.1, t=-1.81, P<0.05). There were also significant improvements for the intervention group in activity levels and aspects of health related quality of life.

Conclusion: Current secondary prevention strategies for stroke patients are reliant upon pharmacological therapies for managing a lifestyle related disease. This is the first trial to suggest that existing NHS lifestyle modification programmes are an effective and feasible means of reducing the risk of future cardiovascular events.

PDF
Final_thesis.pdf - Other
Download (2MB)

More information

Published date: November 2012
Organisations: University of Southampton, Faculty of Health Sciences

Identifiers

Local EPrints ID: 346055
URI: http://eprints.soton.ac.uk/id/eprint/346055
PURE UUID: cf9ef596-f6a4-449c-9829-81da25e00620
ORCID for Joy Conway: ORCID iD orcid.org/0000-0001-6464-1526

Catalogue record

Date deposited: 26 Feb 2013 13:05
Last modified: 06 Jun 2018 13:05

Export record

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×